FORM 1023-EZ for NABULSI FOUNDATION INC

Field Data
EIN 82-3623183
Case Number EO-2018038-000108
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NABULSI FOUNDATION INC
Organization’s Mailing Address 2577 GRAND CYPRESS BLVD
City PALM HARBOR
State FL
ZIP 34684
Accounting period End 1
Primary contact name WASSIM NABULSI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WASSIM NABULSI
PRESIDENT
2577 GRAND CYPRESS BLVD
PALM HARBOR FL 34684

Officer/Director/Trustee Two

MOMTAZ MAHAYNI
TREASURER
2577 GRAND CYPRESS BLVD
PALM HARBOR FL 34684

Officer/Director/Trustee Three

DANA AL-HORANI
SECRETARY
10202 DEVONSHIRE LAKE DRIVE
TAMPA FL 33647

Organization’s website
Organization’s email WASSIMNABULSI@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/19/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q19 - Nonmonetary Support N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name WASSIM NABULSI
Signature Title PRESIDENT
Signature Date 2/5/18

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